Aims: Patients with epistaxis typically visit the emergency department for initial treatment. According to recent studies, tranexamic acid (TXA) is effective in the treatment of epistaxis. This study compared the therapeutic superiority of saline to that of 500 and 1000 mg doses of topical TXA for the treatment of anterior epistaxis. Materials and methods: This phase 4 clinical trial was a randomized, controlled, and double-blind trial. A total of 152 patients were divided into three groups. Group 1 was treated with 1000 mg TXA, Group 2 with 500 mg TXA, and Group 3 with saline. Results: Based on multinomial logistic regression analysis, the bleeding frequency at the 5th minute was 2.9 times and rebleeding status was 4.3 times less in Group 1 (1000 mg TXA) than in Group 3 (saline). There were no differences between the three groups in terms of side effects or salvage therapy. Conclusion: In addition to its superiority in treatment, 1000 mg of TXA is recommended because of the decreased rate of recurrent bleeding and low incidence of side effects.

The rate of patients undergoing tomography in the emergency department has increased in the last two decades. In the last few years, there has been a more significant increase due to the effects of the pandemic. This study aimed to determine the rate of patients who underwent chest imaging in the emergency department, the preferred imaging method, and the demographic characteristics of the patients undergoing imaging during the pre-pandemic and post-pandemic periods. This retrospective cross-sectional study included patients admitted to the emergency department between January 2019 and March 2023. The number of female, male, and total emergency admissions, the rate of patients who underwent chest X-ray (CXR) and chest computed tomography (CCT), and the age and gender distribution of the cases who underwent chest imaging were compared according to the pre-pandemic (January 2019–February 2020), pandemic (March 2020–March 2022), and post-pandemic (April 2022–March 2023) periods. Total emergency admissions were similar in the pre-pandemic and post-pandemic periods (pre-pandemic period: 21,984 ± 2087; post-pandemic period: 22,732 ± 1701). Compared to the pre-pandemic period, the CCT rate increased (pre-pandemic period: 4.9 ± 0.9, post-pandemic period: 7.46 ± 1.2), and the CXR rate decreased (pre-pandemic period: 16.6 ± 1.7%, post-pandemic period: 13.3 ± 1.9%) in the post-pandemic period (p < 0.001). The mean age of patients who underwent chest imaging (CXR; Pre-pandemic period: 56.6 ± 1.1 years; post-pandemic period: 53.3 ± 5.6 years. CCT; Pre-pandemic period: 68.5 ± 1.7 years; post-pandemic period: 61 ± 4.0 years) in the post-pandemic period was lower than in the pre-pandemic period (p < 0.001). Chest imaging preferences in the emergency department have changed during the post-pandemic period. In the post-pandemic period, while younger patients underwent chest imaging in the emergency department, CCT was preferred, and the rate of CXR decreased. It is alarming for public health that patients are exposed to higher doses of radiation at a younger age.

Purpose: To investigate the potential protective effect of roxadustat against cisplatin-induced acute kidney injury (AKI) by evaluating biochemical markers, inflammatory parameters, renal function tests, and histopathological changes. Methods: Thirty female Wistar rats were randomized into control group, cisplatin with tap water group, and cisplatin with roxadustat group. Cisplatin-induced AKI was established by intraperitoneal injection of cisplatin at 10 mg/kg for seven days. Roxadustat was administered orally at 20 mg/kg/day to the treatment group. Blood and kidney samples were collected for biochemical and histopathological analyses respectively. Results: Roxadustat treatment significantly reduced markers of renal injury (malondialdehyde (MDA), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), transforming growth factor-beta 1 (TGF-beta1)), inflammatory cytokines (tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18)) compared to the cisplatin group (p < 0.005). In addition, roxadustat treatment also improved renal function (blood urea nitrogen (BUN), serum creatinine (SCr)) compared to the cisplatin group (p < 0.005). Histopathological examination revealed a significant decrease in tubular epithelial necrosis and luminal necrotic debris in the roxadustat-treated group (p < 0.005). However, there was no significant difference in tubular dilatation and interstitial inflammation between groups (p > 0.05). Conclusion: Roxadustat significantly prevents cisplatin-induced AKI by attenuating renal injury, reducing inflammation, and improving renal function. This evidence suggests that roxadustat may be a promising preventive option for patients receiving cisplatin chemotherapy